Effects of simulated sample sizes on the mortality effect estimates in three randomized intensive care unit trials

2020 ◽  
Vol 64 (7) ◽  
pp. 976-981
Author(s):  
Andreas Kofoed ◽  
Anders Perner ◽  
Søren Marker ◽  
Nicolai Haase ◽  
Lars B. Holst ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sample Sizes ◽  
Simulated Sample ◽  
Mortality Effect

scholarly journals Frequency of Electrolyte Disorders and Its Effect On Mortality Among Children Admitted In Pediatric Intensive Care Unit

2021 ◽  
Vol 10 (02) ◽  
pp. 115-119
Author(s):  
Maryam Haider ◽  
Ammara Hameed ◽  
Sara Fatima ◽  
Meher Afroze ◽  
Nadeem Noor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Serum Sodium ◽  
Laboratory Data ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Electrolyte Disorders ◽  
Mortality Effect ◽  
Sodium And Potassium

Objective: To determine the frequency of electrolyte disorders, i.e., serum sodium and potassium and to evaluate its effect on mortality rate among children admitted at the pediatric intensive care unit. Study Design and Setting: This was a descriptive cross sectional study conducted at Pediatric Intensive care unit of Civil Hospital Karachi from April to December 2017 Methodology: Informed consent was obtained from 150 parents of the children who fulfill the inclusion criteria. Laboratory data (serum sodium and serum potassium) were recorded during the stay in the pediatric intensive care unit. Data was analyzed using SPSS version 20. Mean ± S.D was calculated for quantitative variables. Frequency and percentage were calculated for gender, electrolyte disorders and mortality. Effect modifiers were controlled by stratification of age, gender and electrolyte disorders (Hypernatremia, Hyponatremia, Hyperkalemia, and Hypokalemia). Post-stratification, Chi-squared test was applied. P-value = 0.05 was taken as significant. Results: Out of 150 patients, electrolyte disorders in terms of serum sodium and potassium, were found in 86(57.3%) children. Mortality in children with electrolyte disorders was found to be 46(53.5%) which was significantly higher (P<0.001) than patients without electrolyte disorders 40(46.5%). Hypernatremia was found in 48(32%), hyponatremia 24(16%), hyperkalemia 21(14%) and hypokalemia in 42(28%) patients.In comparison; of electrolyte disorders with mortality; significant association was found in hypernatremia (P<0.001), and hyperkalemia (P<0.001). Conclusion: The most common electrolyte abnormalities were hypernatremia and hypokalemia. Mortality was significantly higher in subjects with electrolyte disorders, especially hypernatremia and hyperkalemia

scholarly journals A Comparison of Methylprednisolone and Dexamethasone in Intensive Care Patients with COVID-19

2021 ◽  
Author(s):  
Justine J. Ko ◽  
Clay Wu ◽  
Neha Mehta ◽  
Noah Wald-Dickler ◽  
Wei Yang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Los Angeles ◽  
Usual Care ◽  
Low Income ◽  
Corticosteroid Treatment ◽  
Intensive Care Patients ◽  
Institutional Review ◽  
Mortality Effect

ABSTRACTOBJECTIVESThis study retrospectively compares the effectiveness of methylprednisolone to dexamethasone in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) requiring ICU care.DESIGNThis is an institutional review board approved cohort study in patients with COVID-19 requiring intensive care unit admission. Patients admitted and requiring oxygen supplementation were treated with either methylprednisolone or dexamethasone.SETTINGThis study takes place in the intensive care units at a large, tertiary, public teaching hospital serving a primarily low-income community in urban Los Angeles.PATIENTSAll eligible patients admitted to the intensive care unit for COVID-19 respiratory failure from March 1 to July 31, 2020 were included in this study.INTERVENTIONSA total of 262 patients were grouped as receiving usual care (n=75), methylprednisolone dosed at least at 1mg/kg/day for ≥ 3 days (n=104), or dexamethasone dosed at least at 6 mg for ≥ 7 days (n=83).MEASUREMENTS and MAIN RESULTSAll-cause mortality within 50 days of initial corticosteroid treatment as compared to usual care was calculated. The mortality effect was then stratified based on levels of respiratory support received by the patient.In this cohort of 262 patients with severe COVID-19, all-cause mortalities in the usual care, methylprednisolone, and dexamethasone groups were 41.3%, 16.4% and 26.5% at 50 days (p <0.01) respectively. In patients requiring mechanical ventilation, mortality was 42% lower in the methylprednisolone group than in the dexamethasone group (hazard ratio 0.48, 95% CI: 0.235-0.956, p=0.0385).CONCLUSIONSIn COVID-19 patients requiring mechanical ventilation, sufficiently dosed methylprednisolone can lead to a further decreased mortality as compared to dexamethasone.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

Coping and Family Relationships in the Neonatal Intensive Care Unit

2014 ◽  
Author(s):  
Gina M. Brelsford ◽  
Kim Doheny ◽  
Kristin Veneman ◽  
Joshua Ramirez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Family Relationships ◽  
Neonatal Intensive Care

Developmental care approaches for mitigating stress in preterm neonates in the neonatal intensive care unit: A systematic review.

2018 ◽  
Vol 11 (2) ◽  
pp. 117-131 ◽  
Author(s):  
Nathália de Figueiredo Silva ◽  
Maria Beatriz Martins Linhares ◽  
Cláudia Maria Gaspardo
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Developmental Care

Caregiver strain and posttraumatic stress symptoms of informal caregivers of intensive care unit survivors.

2016 ◽  
Vol 61 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Sascha A. van den Born-van Zanten ◽  
Dave A. Dongelmans ◽  
Daniela Dettling-Ihnenfeldt ◽  
Roel Vink ◽  
Marike van der Schaaf
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Posttraumatic Stress ◽  
Informal Caregivers ◽  
Caregiver Strain ◽  
Posttraumatic Stress Symptoms ◽  
Stress Symptoms
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